Enrich Community Psychiatry Pllc | |
14821 18th Ave E Tacoma WA 98445-3477 | |
(678) 777-9744 | |
Not Available |
Full Name | Enrich Community Psychiatry Pllc |
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Speciality | Clinic/Center |
Location | 14821 18th Ave E, Tacoma, Washington |
Authorized Official Name and Position | Lucy Waithaka (OWNER OF THE ENTITY) |
Authorized Official Contact | 6787779744 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Enrich Community Psychiatry Pllc 14821 18th Ave E Tacoma WA 98445-3477 Ph: (678) 777-9744 | Enrich Community Psychiatry Pllc 14821 18th Ave E Tacoma WA 98445-3477 Ph: (678) 777-9744 |
NPI Number | 1588432918 |
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Provider Enumeration Date | 12/14/2023 |
Last Update Date | 02/01/2024 |
Certification Date | 02/01/2024 |
Medicare PECOS PAC ID | 9537505235 |
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Medicare Enrollment ID | O20240315000791 |
Identifier | Type | State | Issuer |
---|---|---|---|
1588432918 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Provider Name | Lucy Waithaka |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1992217822 PECOS PAC ID: 6103185988 Enrollment ID: I20221221002906 |
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